Urinary orosomucoid: a new marker of cardiovascular risk in psoriatic patients?

• Published in: Therapeutics and clinical risk management Vol. 15; pp. 831 - 837
• Main Authors: Németh, Balázs, Péter, Iván, Boncz, Imre, Jagicza, Anna, Kiss, István, Csergő, Ágnes, Kőszegi, Tamás, Kustán, Péter, Horváth, Iván G, Ajtay, Zénó
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.07.2019; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Antioxidants; Antioxidants (Nutrients); Arthritis; Atherosclerosis; Biological markers; biomarker; C-reactive protein; Cardiovascular disease; Cardiovascular diseases; cardiovascular risk; Chronic illnesses; Coronary heart disease; Dermatitis; Dermatologic agents; Dermatology; Diabetes; Enzyme-linked immunosorbent assay; Family medical history; Health care; Heart; Heart attack; Heart diseases; High performance liquid chromatography; Inflammation; Inflammatory bowel disease; Ischemia; ISO standards; Laboratories; Lupus; Lupus erythematosus; Mass spectrometry; Medical research; Original Research; orosomucoid; Oxidative stress; Patients; Proteins; Psoriasis; Purines; Rheumatoid arthritis; Rheumatoid factor; Scientific imaging; Skin; Stenosis; Stroke; Systemic lupus erythematosus; Transient ischemic attack; Uric acid; Hungary; United States > US; C-reactive protein; orosomucoid; cardiovascular risk; biomarker; psoriasis; oxidative stress
• ISSN: 1176-6336; 1178-203X; 1178-203X
• DOI: 10.2147/TCRM.S197633

Psoriasis is one of the most common lifelong lasting dermatologic diseases. According to the latest studies, psoriatic patients have a higher risk of developing cardiovascular diseases. Psoriasis is considered as a systemic inflammatory disease. Several oxidative stress markers have been shown to be elevated in psoriasis. However, a panel of biomarkers has not been used yet. This study was aimed at exploring the connection between a panel of biomarkers (C-reactive protein, asymmetric dimethylarginine, uric acid, total antioxidant capacity, malondialdehyde, and orosomucoid [ORM]) and cardiovascular risk in psoriatic patients. The inclusion criterion was the onset of psoriasis with skin lesions. Exclusion criteria were impaired renal function (eGFR<60 mL/min/1.73 m ), acute inflammations (urinary, respiratory, skin inflammation, etc), autoimmune disorders (rheumatoid arthritis, systemic lupus erythematosus, or inflammatory bowel disease), and any kind of biological antipsoriatic treatment. Patients with a medical history of myocardial infarction, coronary heart disease, stroke, transient ischemic attack, and carotid artery stenosis were also excluded. Biomarkers were measured by routine procedures, ELISA and HPLC. QRISK®2-2017 was used to assess 10-year risk of cardiovascular disease development. Psoriasis severity was measured by the Psoriasis Area and Severity Index. One hundred and fourteen psoriatic patients were enrolled. Only urinary orosomucoid and urinary orosomucoid/urinary creatinine (u-ORM/u-CREAT) ratio showed significant correlation with QRISK score (u-ORM, r=0.245; u-ORM/u-CREAT, r=0.309). When comparing mild psoriatic patients to moderate psoriatic patients, significant differences could only be found in u-ORM and u-ORM/u-CREAT ratio. There seems to be a connection between urinary ORM and cardiovascular risk. U-ORM and u-ORM/u-CREAT ratio could be used as an indicator of low-grade inflammation in mild and moderate psoriasis. However, it is the 10-year follow-up of cardiovascular events that will determine the usefulness of this biomarker panel.